Barriers and Facilitators to Testing in Primary Care Among Health Care Providers

Simmons, Emma; Brown, Monique J.; Slye, Kay; Ma, Mindy; Sutton, Madeline Y.; McLellan-Lemal, Eleanor

doi:10.1016/s0027-9684(15)30340-0

Cited by 30 publications

(34 citation statements)

References 12 publications

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“…7 Patients want to be tested. 8 However, physicians face numerous HIV testing barriers, including physician discomfort with initiating HIV testing discussions, 9 physicians not realizing that patients expect HIV testing to be done, 8 time, 10,11 and competing clinical priorities. 11,12 A pioneering intervention to improve HIV testing in health care settings may be a patientinitiated approach.…”

mentioning

confidence: 99%

Mitigating HIV Health Disparities: The Promise of Mobile Health for a Patient-Initiated Solution

Arya

Kumar²,

Patel³

et al. 2014

Am J Public Health

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The HIV epidemic is an ongoing public health problem fueled, in part, by undertesting for HIV. When HIV-infected people learn their status, many of them decrease risky behaviors and begin therapy to decrease viral load, both of which prevent ongoing spread of HIV in the community. Some physicians face barriers to testing their patients for HIV and would rather their patients ask them for the HIV test. A campaign prompting patients to ask their physicians about HIV testing could increase testing. A mobile health (mHealth) campaign would be a low-cost, accessible solution to activate patients to take greater control of their health, especially populations at risk for HIV. This campaign could achieve Healthy People 2020 objectives: improve patient-physician communication, improve HIV testing, and increase use of mHealth.

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confidence: 99%

Mitigating HIV Health Disparities: The Promise of Mobile Health for a Patient-Initiated Solution

Arya

Kumar²,

Patel³

et al. 2014

Am J Public Health

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show abstract

“…However, challenges in routinely screening for HIV as recommended by the Centers for Disease Control and Prevention [26] and the United States Preventive Services Task Force [27] even in public health care settings are also prevalent and were recently described by a local DC HIV physician provider; improving health care provider awareness about routine HIV screening and accountability to perform HIV screening were suggested solutions [28]. Challenges reported by some physicians include discomfort engaging in sexual history discussions with patients, time constraints, confidentiality issues, and lack of knowledge regarding appropriate reimbursement procedures for HIV testing and treatment referrals [29][30][31][32]. Addressing HIV in DC also includes HIV education efforts with DC physicians and other providers to increase routine HIV testing efforts and to ensure rapid linkage to HIV care and treatment services for those who test positive.…”

Section: Discussionmentioning

confidence: 99%

Sociostructural Correlates of AIDS Progression for African American Women Living with Diagnoses of HIV Infection in the District of Columbia

et al. 2013

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“…Lack of time seems to pervade health systems: time and financial constraints, and lack of training inhibited the provision of routine HIV testing even in developed country settings such as the USA (Simmons et al 2011). …”

Section: Methodsmentioning

confidence: 99%

Enhancing HIV Treatment Access and Outcomes Amongst HIV Infected Children and Adolescents in Resource Limited Settings

Goga

Singh

et al. 2016

Matern Child Health J

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Introduction Increasing access to HIV-related care and treatment for children aged 0–18 years in resource-limited settings is an urgent global priority. In 2011–2012 the percentage increase in children accessing antiretroviral therapy was approximately half that of adults (11 vs. 21 %). We propose a model for increasing access to, and retention in, paediatric HIV care and treatment in resource-limited settings. Methods Following a rapid appraisal of recent literature seven main challenges in paediatric HIV-related care and treatment were identified: (1) lack of regular, integrated, ongoing HIV-related diagnosis; (2) weak facility-based systems for tracking and retention in care; (3) interrupted availability of dried blood spot cards (expiration/stock outs); (4) poor quality control of rapid HIV testing; (5) supply-related gaps at health facility-laboratory interface; (6) poor uptake of HIV testing, possibly relating to a fatalistic belief about HIV infection; (7) community-associated reasons e.g. non-disclosure and weak systems for social support, resulting in poor retention in care. Results To increase sustained access to paediatric HIV-related care and treatment, regular updating of Policies, review of inter-sectoral Plans (at facility and community levels) and evaluation of Programme implementation and impact (at national, subnational, facility and community levels) are non-negotiable critical elements. Additionally we recommend the intensified implementation of seven main interventions: (1) update or refresher messaging for health care staff and simple messaging for key staff at early childhood development centres and schools; (2) contact tracing, disclosure and retention monitoring; (3) paying particular attention to infant dried blood spot (DBS) stock control; (4) regular quality assurance of rapid HIV testing procedures; (5) workshops/meetings/dialogues between health facilities and laboratories to resolve transport-related gaps and to facilitate return of results to facilities; (6) community leader and health worker advocacy at creches, schools, religious centres to increase uptake of HIV testing and dispel fatalistic beliefs about HIV; (7) use of mobile communication technology (m-health) and peer/community supporters to maintain contact with patients. Discussion and Conclusion We propose that this package of facility, community and family-orientated interventions are needed to change the trajectory of the paediatric HIV epidemic and its associated patterns of morbidity and mortality, thus achieving the double dividend of improving HIV-free survival.

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Barriers and Facilitators to Testing in Primary Care Among Health Care Providers

Cited by 30 publications

References 12 publications

Mitigating HIV Health Disparities: The Promise of Mobile Health for a Patient-Initiated Solution

Mitigating HIV Health Disparities: The Promise of Mobile Health for a Patient-Initiated Solution

Sociostructural Correlates of AIDS Progression for African American Women Living with Diagnoses of HIV Infection in the District of Columbia

Enhancing HIV Treatment Access and Outcomes Amongst HIV Infected Children and Adolescents in Resource Limited Settings

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